DR. RICHARD JOHN WAGNER JR. (NPI# 1639794589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639794589 |
| Entity Type | Individual |
| Full Name | DR. RICHARD JOHN WAGNER JR. |
| Credential | DO |
| Practice Address |
5515 Peach St Erie PA 16509-2695 |
| Mailing Address |
3915 Ellsworth Ave Erie PA 16509-1017 |
| Practice Telephone | 8148644031 |
| Mailing Telephone | 2536772919 |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2020-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | OT020105 | PA | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528304334 | Richard Wagner | Counselor | 5132 Mimosa Drive, Bellaire, TX 77401 | 2012-12-26 |
| 1326359423 | Richard Ross Wagner | Pharmacist | 3282 Bethel Rd Se, Port Orchard, WA 98366-5603 | 2010-06-23 |
| 1871814624 | Richard Adam Wagner | Family Medicine | 295 County Hwy. 156, Johnstown, NY 12095-4123 | 2010-06-16 |
| 1134443559 | Richard Alan Wagner | Pharmacist | 23631 Dane Ct, Laguna Niguel, CA 92677-4618 | 2010-03-15 |
| 1043470214 | Richard W Wagner Jr. | Dentist | 123 W Franklin St, Suite 201, Chapel Hill, NC 27516-2524 | 2008-06-11 |
| 1962621631 | Richard Wagner | Specialist | 1789 Rebecca Lane, Coupeville, WA 98239-0339 | 2007-04-24 |
| 1770700957 | Richard M Wagner | Dentist | 1925 South Green Bay Rd, Racine, WI 53406-4654 | 2007-04-19 |
| 1619019676 | Richard Chisholm Wagner | Dentist | 1150 S King St Ste 303, Honolulu, HI 96814-1951 | 2007-02-13 |
| 1134236334 | Richard Laverne Wagner | Psychiatry & Neurology | 12 Benevolent St, Providence, RI 02906-1103 | 2006-08-24 |
| 1669488946 | Richard Wagner | Psychiatry & Neurology | 101 Lions Dr, Suite 119, Barrington, IL 60010-3181 | 2006-07-31 |
| Street Address |
5515 PEACH ST |
| City | ERIE |
| State | PA |
| Zip Code | 16509-2695 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548263973 | Millcreek Community Hospital | General Acute Care Hospital | 5515 Peach St, Erie, PA 16509-2603 | 2005-05-31 |
| 1942814546 | Zeinab Altaher | Pharmacist | 5515 Peach St, Erie, PA 16509-2603 | 2020-09-02 |
| 1669086161 | Mikayla Erin Matheny | Pharmacist | 5515 Peach St, Erie, PA 16509-2695 | 2020-09-02 |
| 1467065615 | Ashley Diane Crandall | Pharmacist | 5515 Peach St, Erie, PA 16509-2603 | 2020-08-27 |
| 1538787221 | Lex Herwen Barte I | Podiatrist | 5515 Peach St, Erie, PA 16509-2603 | 2020-07-08 |
| 1831717826 | Usman Ahmed | Internal Medicine | 5515 Peach St, Erie, PA 16509-2603 | 2020-07-07 |
| 1871110700 | Peter Vincent Finelli | Family Medicine | 5515 Peach St, Erie, PA 16509-2695 | 2020-06-26 |
| 1376160366 | Leng Xiong | Podiatrist | 5515 Peach St, Erie, PA 16509-2603 | 2020-06-25 |
| 1811514805 | Michael Driscoll | Orthopaedic Surgery | 5515 Peach St, Erie, PA 16509-2603 | 2020-06-25 |
| 1750908745 | Morgan Michele Gallo | Podiatrist | 5515 Peach St, Erie, PA 16509-2603 | 2020-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598243073 | Austin Dudenhoefer | Physical Therapist | 8270 Peach St Ste 400, Erie, PA 16509 | 2018-08-06 |
| 1770092884 | Latasha Marie Phillips | Social Worker | 5100 Peach Street, Erie, PA 16509 | 2017-09-21 |
| 1932621307 | Mitchell Meagher | Internal Medicine | 5515 Peach St., Attn: Medical Education, Erie, PA 16509 | 2017-07-07 |
| 1760903702 | Tricia Lee Cubitt | Social Worker | 4756 Springview Drive, Apartment 310, Erie, PA 16509 | 2017-06-29 |
| 1790191617 | Ashley Russell | Physical Therapy Assistant | 1267 South Hill Road, Erie, PA 16509 | 2014-07-11 |
| 1295084085 | Michael David Mccafferty | Internal Medicine | 5332 Rome Court Drive, 301, Erie, PA 16509 | 2012-09-07 |
| 1427303619 | Michelle Mary Dillaene Tobin | Social Worker | 828 W. Gore Road, Erie, PA 16509 | 2012-07-13 |
| 1962761411 | Moshood B Martins | Dentist | 7040 Peach Street, Erie, PA 16509 | 2012-05-03 |
| 1770854549 | Peach Street Dental & Dentures, PC. | Dentist | 7040 Peach St, Erie, PA 16509 | 2012-01-25 |
| 1881989515 | Richard R Sambuchino | Dentist | 4944 Peach Street, Erie, PA 16509 | 2011-06-10 |
| Find all providers in zip 16509 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952913907 | Alexandria Parker | Student in an Organized Health Care Education/Training Program | 535 Brennan Cir, Erie, CO 80516-7049 | 2020-08-20 |
| 1568087542 | Jason Latsky | Student in an Organized Health Care Education/Training Program | 232 W 25th Street, Erie, PA 16544 | 2020-06-15 |
| 1366071029 | Claire Catherine Kenny | Student in an Organized Health Care Education/Training Program | 232 Seminole Dr, Erie, PA 16505-2422 | 2020-04-05 |
| 1679102321 | Brady Bianco | Student in an Organized Health Care Education/Training Program | 5903 Garries Rd, Erie, PA 16506-4806 | 2020-04-05 |
| 1275198723 | Ram Baboo | Student in an Organized Health Care Education/Training Program | 120 East 2nd Street Upmc Northshore Neurology, 3rd Floor, Erie, PA 16507 | 2019-05-09 |
| 1396208070 | Jackson Joseph Bell | Student in an Organized Health Care Education/Training Program | Upmc Hamot, 201 State Street, Erie, PA 16550 | 2019-04-10 |
| 1346700234 | Mark Fadel | Student in an Organized Health Care Education/Training Program | 1645 W 8th St Ste 200, Erie, PA 16505-5007 | 2019-03-25 |
| 1144712084 | Kathlyn Elise Callenius | Student in an Organized Health Care Education/Training Program | 120 East Second St, 3rd Floor, Erie, PA 16507 | 2018-06-06 |
| 1023505005 | Carter Mccance Denne | Student in an Organized Health Care Education/Training Program | Upmc Hamot 201 State Street, Erie, PA 16550 | 2018-04-16 |
| 1851895858 | Ramandeep Kaur Dhaliwal | Student in an Organized Health Care Education/Training Program | 4427 Hammocks Dr Apt 301, Erie, PA 16506-7421 | 2018-03-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.